Thomas F. Imperiale, MD; David R. Wagner, MS; Ching Y. Lin, BS; Gregory N. Larkin, MD; James D. Rogge, MD; David F. Ransohoff, MD
A clinical prediction rule incorporating age, sex, and endoscopic findings within reach of a flexible sigmoidoscope identified a subgroup at very low risk for advanced neoplasia in the proximal colon. If the prediction rule consistently identifies a group at similarly low risk in other cohorts of patients, it could be the basis for selecting patients for endoscopic screening for colorectal cancer.
Ann Intern Med. 2003;139(12):959-965. doi:10.7326/0003-4819-139-12-200312160-00005
Leslie K. Dennis, MS, PhD; Laura E. Beane Freeman, PhD; Marta J. VanBeek, MD
Despite earlier reports that sunscreen use was associated with melanoma, the authors found no evidence in the published literature for this association. Previous studies that showed an association between sunscreen use and melanoma risk may have failed to control for factors that influence both sunscreen use and the risk for melanoma.
Ann Intern Med. 2003;139(12):966-978. doi:10.7326/0003-4819-139-12-200312160-00006
Charles A. Henrikson, MD, MPH; Eric E. Howell, MD; David E. Bush, MD; J. Shawn Miles, MD; Glenn R. Meininger, MD; Tracy Friedlander; Andrew C. Bushnell, MD; Nisha Chandra-Strobos, MD
Contrary to common belief, relief of chest pain with nitroglycerin did not predict active coronary artery disease in patients admitted for acute chest pain.
Ann Intern Med. 2003;139(12):979-986. doi:10.7326/0003-4819-139-12-200312160-00007
Lee Goldman, MD; Ajay J. Kirtane, MD*
The basis of this article is a patient who was sent home from the emergency department after presenting with chest pain. Later events proved that the patient had a myocardial infarction. The authors discuss the diagnosis and triage of patients presenting with acute chest pain or with symptoms consistent with possible cardiac ischemia.
Ann Intern Med. 2003;139(12):987-995. doi:10.7326/0003-4819-139-12-200312160-00008
C. Daniel Meyers, MD; Molly C. Carr, MD; Sang Park, PhD; John D. Brunzell, MD
No-flush niacin preparations that do not require a prescription for purchase do not contain any free nicotinic acid and are without value for treating dyslipidemia. Sustained-release niacin available without prescription does contain free nicotinic acid, but some brands are hepatotoxic. Immediate-release niacin contains free nicotinic acid and is the least expensive form of over-the-counter niacin.
Ann Intern Med. 2003;139(12):996-1002. doi:10.7326/0003-4819-139-12-200312160-00009
Vincenza Snow, MD; Kevin B. Weiss, MD, MPH; Michael LeFevre, MD, MSPH; Robert McNamara, MD, MHS; Eric Bass, MD, MPH; Lee A. Green, MD, MPH; Keith Michl, MD; Douglas K. Owens, MD; Jeffrey Susman, MD; Deborah I. Allen, MD; Christel Mottur-Pilson, PhD; and the Joint AAFP/ACP Panel on Atrial Fibrillation
This paper summarizes the recommendations of the Joint Panel of the American Academy of Family Physicians and the American College of Physicians for managing a first episode of atrial fibrillation in adults.
Ann Intern Med. 2003;139(12):1009-1017. doi:10.7326/0003-4819-139-12-200312160-00011
Robert L. McNamara, MD, MHS; Leonardo J. Tamariz, MD, MPH; Jodi B. Segal, MD, MPH; Eric B. Bass, MD, MPH
This review, which supports the recommendations of the American Academy of Family Physicians and the American College of Physicians, summarizes the available evidence about the efficacy of medications used for ventricular rate control, stroke prevention, acute rhythm conversion, and maintenance of sinus rhythm. The review also discusses the efficacy of electrical cardioversion and the use of echocardiography in patients with atrial fibrillation.
Ann Intern Med. 2003;139(12):1018-1033. doi:10.7326/0003-4819-139-12-200312160-00012
Sidney J. Winawer, MD
In this issue, Imperiale and colleagues take a systematic approach to examining clinical and flexible sigmoidoscopy findings that identify patients who have the lowest risk for advanced adenomas in the proximal colon. Their findings suggest a screening colonoscopy strategy that makes the best use of the test's high diagnostic accuracy and avoids exposure to its expense, inconvenience, and risk when the predicted yield is low. Whether this strategy will conserve resources remains to be determined.
Ann Intern Med. 2003;139(12):1034-1035. doi:10.7326/0003-4819-139-12-200312160-00013
Raymond J. Gibbons, MD
The study by Henrikson and colleagues in this issue is an important addition to the evidence on the diagnostic value of chest pain relief by nitroglycerin. The response to sublingual nitroglycerin had no diagnostic value in patients who developed chest pain (presumably at rest) under medical supervision after admission. Do these findings mean that we should stop using the response to nitroglycerin to help diagnose patients with chronic chest pain?
Ann Intern Med. 2003;139(12):1036-1037. doi:10.7326/0003-4819-139-12-200312160-00014
Christine Laine, MD, MPH, Senior Deputy Editor; Cynthia Mulrow, MD, MSc, Deputy Editor; for the Editors
In this issue, Annals salutes the individuals who reviewed manuscripts over the past year. This editorial reflects on the value, quality, and future of peer review.
Ann Intern Med. 2003;139(12):1038-1040. doi:10.7326/0003-4819-139-12-200312160-00015
Ted Louie, MD
In my second year of private practice, as the junior partner, I expected to be on call on Christmas. That was only fair, it seemed. But it didn't seem all that fair when Christmas Day actually came around. There I was, in the hospital, doing consultations and seemingly endless rounds, as the rest of the world enjoyed the day in the company of family and friends.
Ann Intern Med. 2003;139(12):1041. doi:10.7326/0003-4819-139-12-200312160-00016
Louis D. Boshes, MD
It was early on Christmas Eve, 24 December 1943, and I was far away from home on duty at a U.S. Navy medical facility. I had always requested duty on holidays to cover for my medical buddies who were not of my own faith, and they did the same for me. My patients were a large group of 17-, 18-, and 19-year-old Marines fresh off Guadalcanal, where they had aged so rapidly in combat with enemies and tropical illnesses. They were truly ill, both physically and emotionally.
Ann Intern Med. 2003;139(12):1042. doi:10.7326/0003-4819-139-12-200312160-00017
Ann Intern Med. 2003;139(12):1043. doi:10.7326/0003-4819-139-12-200312160-00018
Ann Intern Med. 2003;139(12):1043. doi:10.7326/0003-4819-139-12-200312160-00019
Ann Intern Med. 2003;139(12):1043-1044. doi:10.7326/0003-4819-139-12-200312160-00020
Ann Intern Med. 2003;139(12):1044. doi:10.7326/0003-4819-139-12-200312160-00021
Ann Intern Med. 2003;139(12):1044-1045. doi:10.7326/0003-4819-139-12-200312160-00022
Ann Intern Med. 2003;139(12):1045. doi:10.7326/0003-4819-139-12-200312160-00023
Ann Intern Med. 2003;139(12):1045-1046. doi:10.7326/0003-4819-139-12-200312160-00024
Ann Intern Med. 2003;139(12):1046-1047. doi:10.7326/0003-4819-139-12-200312160-00025
Ann Intern Med. 2003;139(12):W-84. doi:10.7326/0003-4819-139-12-200312160-w1
Ann Intern Med. 2003;139(12):W-85. doi:10.7326/0003-4819-139-12-200312160-w2
Ann Intern Med. 2003;139(12):W-86. doi:10.7326/0003-4819-139-12-200312160-w3
Ann Intern Med. 2003;139(12):1049-1054. doi:10.7326/0003-4819-139-12-200312160-00031
Ann Intern Med. 2003;139(12):I-10. doi:10.7326/0003-4819-139-12-200312160-00001
Ann Intern Med. 2003;139(12):I-16. doi:10.7326/0003-4819-139-12-200312160-00002
Ann Intern Med. 2003;139(12):I-30. doi:10.7326/0003-4819-139-12-200312160-00003
Ann Intern Med. 2003;139(12):I-32. doi:10.7326/0003-4819-139-12-200312160-00004
Helen Chen, MD
Ann Intern Med. 2003;139(12):1048. doi:10.7326/0003-4819-139-12-200312160-00029
Paul E. Epstein, MD
Ann Intern Med. 2003;139(12):1048. doi:10.7326/0003-4819-139-12-200312160-00030
Ann Intern Med. 2003;139(12):No Pagination Specified. doi:10.7326/0003-4819-139-12-200312160-00033
Rosanne M. Leipzig, MD, PhD
This Update focuses on a variety of topics in the field: disease prevention and health promotion, cognitive training, physical exercise, glaucoma prevention, cardiovascular disease, and late-life depression.
Ann Intern Med. 2003;139(12):1003-1008. doi:10.7326/0003-4819-139-12-200312160-00010
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